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Heart defect poses low risk in pregnancy

Wednesday October 13th 2021

There is "reassuringly low" maternal mortality among women with congenital heart disease during pregnancy and birth, according to an analysis published today.

There remains relatively high morbidity among this group, according to findings published in the European Heart Journal.

Many more people with congenital heart disease are reaching adulthood and aiming to start a family, explain Dr Astrid Lammers of University Hospital Munster, Germany, and colleagues. But there is limited research on the risks to mother and child.

The authors analysed information from 2005 to 2018 taken from a large German health insurance company. This included 7,512 pregnancies in 4,015 women with congenital heart disease and 11,225 pregnancies in 6,502 comparable women with normal hearts.

This showed that there was "no excess mortality" for women with congenital heart disease, although caesarean delivery was significantly more likely.

The maternal complication rate was low, but stroke, heart failure and cardiac arrhythmias during pregnancy were significantly raised.

Similarly, neonatal mortality was low but significantly higher in the congenital heart disease group. Among the infants themselves, congenital heart disease was over six times higher than for other infants.

The authors point out that this study was based in a highly developed health care system, "nevertheless, maternal morbidity and neonatal morbidity/mortality were significantly increased in women with adult congenital heart disease highlighting the need of specialised care and pre-pregnancy counselling".

Dr Lammers said: “Counselling is a very important part of the care of every woman with a congenital heart defect and should start at an early age. It appears to work in developed countries such as Germany, as suggested by the lack of deaths among the mothers.

"This is probably due to avoiding very high-risk pregnancies and appropriate management of pregnancy”

Lammers, A. E. et al. Maternal and neonatal complications in women with congenital heart disease: a nationwide analysis. European Heart Journal 12 October 2021 doi: 10.1093/eurheartj/ehab571

[abstract]

Tags: Child Health | Childbirth and Pregnancy | Europe | Heart Health | Nursing & Midwifery | Women's Health & Gynaecology

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